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Clinical science shows common therapy options for psoriasis (PSO)-a chronic inflammatory skin disease can reduce coronary plaque and make the plaque becomes less inflammatory over time harboring fewer characteristics prone to rupture and cause a heart attack. It is the first-in-human observational study demonstrating that treating remote inflammation in the body can modulate coronary disease.
It is associated with an accelerated risk of myocardial infarction and has an increased risk for atherogenesis, which is the development of plaque within the walls of blood vessels. A significant reduction in adverse cardiovascular events targeting interleukin-1 beta (IL1B), a cytokine that is central to the inflammatory response. Anti-tumor necrosis factor (TNF) agents are commonly used, biologic, and FDA-approved immunomodulatory treatment options for PSO.
More than 80 consecutive patients were stratified by biologic treatment (predominantly anti-TNF; n=57) and non-biologic treatment (n= 27). Non-calcified burden (NCB), plaque volume (PV), and maximal artery stenosis in the proximal vessels (diameter>2mm) were blindly assessed based on coronary CT angiography using dedicated software.
The patients were middle-aged and at low cardiovascular risk by traditional risk scores.
At one-year, the plaque volume in the biologic treated group decreased by 40 percent (p=0.002), a finding not observed in those without treatment (p=0.04). Trends in NCB and maximal stenosis were significant and consistent with PV in both groups. Furthermore, change in PV was also positively associated with a change in IL1B (β=0.56, p=0.03), even after adjustment for traditional cardiovascular risk factors and statin use.
To see a reduction in coronary plaque one year of biologic therapy alone is incredible and very assuring, treatment of a skin disease with biologic therapy have an impact specifically on plaque in the coronary,” said Nehal N. Mehta, MD MSCE FAHA, the Principal Investigator of the study from the National Heart, Lung, and Blood Institute. Patients maintaining and treating psoriasis to decrease the risks of adverse cardiovascular events occurring. This shows how anti-inflammatory therapy options could impact coronary plaque over time.
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